If you fire your doctor, should you tell him why?

Cindysphinx

G.O.A.T.
One of my kids has a doctor, and I am likely to dismiss him and start taking the child to someone else.

When I call this current doctor and cancel the appointment and request a records transfer, I predict he will ask me why. I am wondering what I should say and how much detail I should provide.

Part of the problem is lack of rapport with the child, which probably isn't entirely the doctor's fault. The rapport issue alone would not cause me to switch, although I think we could find someone better.

Another part of the problem is that the doctor yawns a lot when my child is talking to him during visits. Not little, stifled yawns. Big ones, as though this doctor has not slept in weeks. These yawns are so huge that my child will stop talking and say, "Bless you." I would hope my child's difficulties are not that boring.

The third part of the problem is I feel like this guy always has one hand in my wallet. His fees are high and he is out of network, which I knew from the outset, of course. But he has asked me to fill out questionnaires and forms, and then billed me $$$ for reading what I wrote.

One billing episode in particular rubbed me the wrong way. The doctor requires 24 hours for a cancellation, which is not unusual, and the full fee is owed for a no-show or late cancellation, etc. Well, we had a morning appointment scheduled and my child had an episode of the type for which the child needed treatment. Without getting into details, let's say the child had an adverse reaction to a medication the doc had prescribed. I realized that we would never make the morning appointment because I had to get the child stabilized. I called, and the doc gave me an afternoon appointment and some advice on stabilizing the child, which took a few hours.

When we showed up for the afternoon appointment, the doc said we would owe the full fee for the afternoon appointment, the cost of the telephone call, and the missed appointment fee (although he reduced that $222 fee by half). I had to cut a check for $422 that day, much of it not eligible for insurance reimbursement. This seemed extreme to me, and I felt like he should have just charged for the afternoon appointment because of the circumstances.

So. Should I give a reason why we are leaving the practice, and if so, how detailed should I be? Or should I just leave and say nothing?
 

jrod

Hall of Fame
^^^ The fact of the matter is he is legally obliged to transfer your records at your request. You, on the other hand, do not have to give any reason for why you are asking for the records to be transferred.

Hopefully you have someone better in mind (i.e. not moving from the frying pan to the fire).
 

hollywood9826

Hall of Fame
If it makes you feel better than let him know. Because theres a good chance the doc could care less. But maybe he does care and tries to make it right though I doubt it.

But the fact that hes out of network would be enough for me. Unless he was a good doc, other wise I'd just let him know the extra cost is not justified anymore.
 

ollinger

G.O.A.T.
Doesn't matter terribly much. It's fairly common for people to change doctors for rapport or financial reasons; we in medical practice see it as fairly routine, and the things that trouble you most about this guy (fees, personality) don't sound like things he's likely to want to change. I don't think he should have charged you for both the missed and kept appointment in the example you cite, and most doctors would have taken it as a change of appointment and just charged for the kept appointment. As for the yawns, pediatricians are often awakened in the middle of the night, sometimes many times, because they need to be available to the patients. Perhaps you should be more understanding of that.
 

jswinf

Professional
Your child's new physician should be able to handle the records transfer with your signed authorization.

Your input to the former doctor could maybe make him a better person and/or doctor, but then again it might not. Explaining your dissatisfaction would probably be the noble thing to do, but you might just want to put it behind you and move on.

Of course, if you really want to let the guy have it, go for it.
 

sureshs

Bionic Poster
Doesn't matter terribly much. It's fairly common for people to change doctors for rapport or financial reasons; we in medical practice see it as fairly routine, and the things that trouble you most about this guy (fees, personality) don't sound like things he's likely to want to change. I don't think he should have charged you for both the missed and kept appointment in the example you cite, and most doctors would have taken it as a change of appointment and just charged for the kept appointment. As for the yawns, pediatricians are often awakened in the middle of the night, sometimes many times, because they need to be available to the patients. Perhaps you should be more understanding of that.

Why should she be more understanding of that? It is not like a grocery store clerk yawning. We are talking about a certified professional who can screw up people's lives. If he can't take the heat, someone else should get the job.
 

jrod

Hall of Fame
^Should I tell the truth if he asks?

'Cause ya know he's gonna ask.


I don't know Cindy. I'd really have to be in your shoes to answer that question. I suppose if I thought it might make things better in the long run for everyone I might be inclined to tell him. Otherwise, I'd probably not provide any feedback (which is not the same thing as saying nothing).
 

Talker

Hall of Fame
If your not happy just change doctors, don't worry about anything.

After all, I'm sure he didn't worry about your financial situation when he gave you the bill.
 

ollinger

G.O.A.T.
sureshs
what a curious analogy! Last time I checked, my grocery clerk wasn't reachable at 3 AM in case I wanted to know what aisle the canned peas were in. Cindy empathetic-as-a-sphinx either thinks the doctor is yawning deliberately, in which case she may need therapy herself, or she thinks he is tired, in which case she could be a little understanding. Every pediatrician I know, and it's many, is frequently fatigued after a night on call. That's normal, and has nothing to do with being able to "take the heat." I suspect she chose this out-of-network guy for the same reason anyone else goes out of network -- because he's well regarded. If her plumber or carpenter yawned, would she be offended? I suspect not. They are allowed to be fatigued. Parents can be very narcissistic -- he yawned with MY child!!!
 
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Cindysphinx

G.O.A.T.
Ollinger, the repeated yawning happens *every* visit.

It's just not good listening skills. I mean, if I were meeting with a client and blasted off huge yawns, this would not go over well and I wouldn't have many clients.
 
D

decades

Guest
just say you want to go in a new direction. It is a multi use statement perfect for many occasions.
 

r2473

G.O.A.T.
sureshs
what a curious analogy! Last time I checked, my grocery clerk wasn't reachable at 3 AM in case I wanted to know what aisle the canned peas were in. Cindy empathetic-as-a-sphinx either thinks the doctor is yawning deliberately, in which case she may need therapy herself, or she thinks he is tired, in which case she could be a little understanding. Every pediatrician I know, and it's many, is frequently fatigued after a night on call. That's normal, and has nothing to do with being able to "take the heat." I suspect she chose this out-of-network guy for the same reason anyone else goes out of network -- because he's well regarded. If her plumber or carpenter yawned, would she be offended? I suspect not. They are allowed to be fatigued. Parents can be very narcissistic -- he yawned with MY child!!!

If Cindy still liked this guy, he could spit in her face and she would smile. As she is clearly annoyed with the guy for some reason, the fact that he breathes is going to be perceived as annoying (Really? He yawns too much? But to be honest, my wife is hyper-sensitive to stuff like this too whereas I wouldn't even notice it).

I think this "marriage" is over. No need to have the doc sign the divorce papers. I would suspect that you are somewhat obvious in your dislike of his habits (you know, those "subtle" little things that we all do to let the other guy know what we think of him).

I guess in short, if you want to "tell the guy off" one more time, then do it and enjoy it. Let him know exactly what you think of him. Could be a worthwhile exercise for you. I doubt he will care one way or the other. My guess is he might be as eager to get rid of you as you are to get rid of him.
 
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Steady Eddy

Legend
Switch doctors. If he asks why, (I think he might not ask), say it's because he's out of network. Going into more details might anger him, and that might bite you back someday, (how? it might, you just never know).

It's like any kind of break up. Just keep it short, don't make it personal, and then it's done. :)
 

RoddickAce

Hall of Fame
Switch doctors. If he asks why, (I think he might not ask), say it's because he's out of network. Going into more details might anger him, and that might bite you back someday, (how? it might, you just never know).

It's like any kind of break up. Just keep it short, don't make it personal, and then it's done. :)

Agreed...;)
 
Cindysphinx, you have every right to request that your medical records are transferred to a new physician (pediatrician). The choice of which Doctor your child goes to is your decision. Feel free to be honest with him as it may help him improve his practice as to many future patients. All the best.
 
Funniest part of this thread is that the OP seems to have no complaint about the quality of the medical care dispensed. She goes out-of-network and then complains she's paying too much, complains because the guy often seems tired (very good doctors frequently are tired because their practices are so busy). Oh my!!! Personally, I was quite satisfied when my kids got good medical care and never begrudged the guy a yawn. Yes, by all means change doctors and hope the next one isn't a well-rested screw-up.
 

brad1730

Rookie
I agree with Steady - but I would add a slight jab. I would say that I wasn't happy about the double bill, but that the main reason is that the out-of-network bills are killing me.

By the way, when someone yawns like that when I'm paying them I say 'you must be really tired, did you get enough sleep last night?'
 

Cindysphinx

G.O.A.T.
Funniest part of this thread is that the OP seems to have no complaint about the quality of the medical care dispensed. She goes out-of-network and then complains she's paying too much, complains because the guy often seems tired (very good doctors frequently are tired because their practices are so busy). Oh my!!! Personally, I was quite satisfied when my kids got good medical care and never begrudged the guy a yawn. Yes, by all means change doctors and hope the next one isn't a well-rested screw-up.

Had the care been bad, I would have left after the first visit and there would have been no opportunity for these other issues to arise. Obviously.

I hope the new guy will be better. Part of what makes this sort of thing difficult is that the medical needs are ongoing. At what point do you cut your losses (so to speak) and try to find someone who will have better rapport while providing the same or higher level of care? I guess the answer is, "Next week."

What I think I will do is go to the new doctor and if that works out I will ask the new doc to request the records by filling out his forms for the transfer. Then I don't have to have any more contact with old doc.

If old doc calls me and asks, I will tell him why I am changing. If he doesn't, then I am off the hook. And if old doc sends me a huge bill for the transfer of records for a patient he attended for five months . . . well, I wouldn't be surprised.
 
T

TennisandMusic

Guest
I'd say tell him you're leaving and give him a good mooning, but seeing as how he's your Dr. he may have well already seen it.
 

Cindysphinx

G.O.A.T.
Cut your losses? What losses? If your kid got good care, you don't have any losses. Yawn.

This should be obvious, but I will explain it for you.

There is a doctor/patient relationship here. My child has spent time with old doc. The change to a new doctor will result in a lack of continuity of care. Child will have to get to know new doc, and new doc will have to get to know child. Anytime you interrupt care, the loss of continuity of care is a *loss.*

Do you understand yet?

Sheez.
 

Lakoste

Professional
Damn, since when is this "relationship" of the utmost importance?

I bounced around different pediatricians a lot growing up, got pretty standard care everywhere I went. Parents these days like to make a big deal out of everything.
 

Cindysphinx

G.O.A.T.
The importance of the relationship depends on the type of doctor and the patient's condition. If your needs were routine, then routine care was probably all that was needed.
 

Topaz

Legend
Obviously, there is a more serious matter of medical care here than Cindy is willing to divulge on a public board. No problem. There is 'routine' care and then there are specialists...and good specialists can be hard to come by.

I left a specialist once, for an ongoing condition that I have, that simply just was not listening to me nor paying any attention to the questions or information I brought him. He put me on medication for a condition I did not have and which made me very sick. So, making the decision to leave him was a no-brainer.

Thing is, to transfer records, you would have absolutely no contact with the doctor at all. That is the domain of the office staff. Some places, if you drop off a self-addressed and stamped envelope, will mail your records to you free of charge. Some places require a small charge.

Honestly, I think you're making this harder than it has to be...once you decide, you call up the office and tell them you want a copy of your child's records. They will tell you what you need to do (if anything) and that's that. Whether or not you are staying or leaving should not even enter the conversation. You have a right to your records, period.

IMO, everyone should have a copy of their own medical records, regardless if you are staying with or leaving your physician. I think it is part of taking personal responsibility for your own health.
 

Cindysphinx

G.O.A.T.
I'll let you know whether this doc contacts me. Child had an appointment scheduled for next month, and I called yesterday to cancel it. He asked if I wanted to reschedule, and I said, "Not right now." He said, "Is something wrong?" So I said no, everything's fine.

Something tells me he will want to talk about why I'm leaving and I am not done with this yet. I hope I am wrong.
 

tennytive

Hall of Fame
From what I've read, I would have switched a long time ago.

I hope your new doctor is a big improvement. Records transfer should be handled by his staff and not be confrontational.

Your silence should be message enough as to why you're leaving.

Best of luck to your child getting the care with compassion s/he deserves.
 
As a medical provider (dentist) not md, I always want to know why a patient transfers. I don't take things personally and doubt he will either. There's no reason to be nervous to tell him the truth. There's also no reason to tell him if it makes you nervous for whatever reason either. You could easily just say you can better afford an in network provider.

Really curious, is the doc answering the phone?? Is he a new doc or old established doc?

I ask because if he is new, he might really appreciate the feedback. MD's don't get business training and he may have gotten some really bad advice on how to run a practice. Billing for every little thing will drive a lot of pt's away. If he is old and established and can "get away" with his billing practices he likely won't care.

The yawning is really unprofessional. I've been to my childrens pediatricians visits plenty of times and have never seen her yawn once. Also most docs have a rotational system to be on call. They're not on call all hours of the night 24/7.
 

Cindysphinx

G.O.A.T.
As a medical provider (dentist) not md, I always want to know why a patient transfers. I don't take things personally and doubt he will either. There's no reason to be nervous to tell him the truth. There's also no reason to tell him if it makes you nervous for whatever reason either. You could easily just say you can better afford an in network provider.

Really curious, is the doc answering the phone?? Is he a new doc or old established doc?

I ask because if he is new, he might really appreciate the feedback. MD's don't get business training and he may have gotten some really bad advice on how to run a practice. Billing for every little thing will drive a lot of pt's away. If he is old and established and can "get away" with his billing practices he likely won't care.

The yawning is really unprofessional. I've been to my childrens pediatricians visits plenty of times and have never seen her yawn once. Also most docs have a rotational system to be on call. They're not on call all hours of the night 24/7.

Yes, he does answer the phone much of the time, and he keeps his own calendar. He is an older doc. He has an older lady who works the front desk etc., and sometimes she answers.

I know, there are many fibs I could tell. But if he asks who the new doc is, I wouldn't mind telling him. And if I bust out with a bunch of lies about the new guy being closer, in-network, or any of that, I will then get caught in a lie.
 

sureshs

Bionic Poster
sureshs
what a curious analogy! Last time I checked, my grocery clerk wasn't reachable at 3 AM in case I wanted to know what aisle the canned peas were in. Cindy empathetic-as-a-sphinx either thinks the doctor is yawning deliberately, in which case she may need therapy herself, or she thinks he is tired, in which case she could be a little understanding. Every pediatrician I know, and it's many, is frequently fatigued after a night on call. That's normal, and has nothing to do with being able to "take the heat." I suspect she chose this out-of-network guy for the same reason anyone else goes out of network -- because he's well regarded. If her plumber or carpenter yawned, would she be offended? I suspect not. They are allowed to be fatigued. Parents can be very narcissistic -- he yawned with MY child!!!

How would you feel if a police officer yawned when you filed a complaint? Heck, people are reprimanded in the corporate world if they yawn in an important meeting with customers.

A grocery clerk is not paid like a doctor and is not charged with that much responsibility. Very poor analogy.

Maybe the AMA's monopoly on medical college spots should be broken so they can't determine how many doctors society needs, which means guaranteeing how much money they make. Maybe it is time to declare it a free market and produce as many doctors as the market will stand, and then there won't be yawning doctors.

Just this morning I read in the WSJ about a software app marketed by an orthopedic surgeon which informs patients about long waiting times (he keeps them waiting for an hour or more). I was thinking - hey where is the choice here to go somewhere else. Sure enough, a professor had commented in the article that the root problem is less doctors and this just sugarcoats the problem.

Open up the market and then we will see. It ain't difficult to memorize fat textbooks. I know doctors from many countries and they tell me how the medical profession is made out to be way tougher than it really is. I know so many doctors and surgeons who play golf and tennis all weekend and take their "refresher" courses on a cruise.
 

Talker

Hall of Fame
How would you feel if a police officer yawned when you filed a complaint? Heck, people are reprimanded in the corporate world if they yawn in an important meeting with customers.

A grocery clerk is not paid like a doctor and is not charged with that much responsibility. Very poor analogy.

Maybe the AMA's monopoly on medical college spots should be broken so they can't determine how many doctors society needs, which means guaranteeing how much money they make. Maybe it is time to declare it a free market and produce as many doctors as the market will stand, and then there won't be yawning doctors.

Just this morning I read in the WSJ about a software app marketed by an orthopedic surgeon which informs patients about long waiting times (he keeps them waiting for an hour or more). I was thinking - hey where is the choice here to go somewhere else. Sure enough, a professor had commented in the article that the root problem is less doctors and this just sugarcoats the problem.

Open up the market and then we will see. It ain't difficult to memorize fat textbooks. I know doctors from many countries and they tell me how the medical profession is made out to be way tougher than it really is. I know so many doctors and surgeons who play golf and tennis all weekend and take their "refresher" courses on a cruise.

I know 2 friends who became doctors, neither one was exceptional in school but they worked hard and were disciplined. I give them credit for that.

I don't know why some people get freaked out just because someone is a doctor.
 

sureshs

Bionic Poster
I know 2 friends who became doctors, neither one was exceptional in school but they worked hard and were disciplined. I give them credit for that.

I don't know why some people get freaked out just because someone is a doctor.

Yeah it aint a big deal. Just like the dissection you did in high school, only on a human.
 

Lakoste

Professional
Obviously, there is a more serious matter of medical care here than Cindy is willing to divulge on a public board. No problem. There is 'routine' care and then there are specialists...and good specialists can be hard to come by.

Ummm... if good specialists are hard to come by then wouldn't you stick with a good one, regardless if he finds you super boring and yawns all the time around you?

This is one aspect of parenting that isn't tough.
 

Topaz

Legend
Ummm... if good specialists are hard to come by then wouldn't you stick with a good one, regardless if he finds you super boring and yawns all the time around you?

This is one aspect of parenting that isn't tough.

*shrug* That's Cindy's decision to make here, not mine. But there is obviously some other consideration here that she isn't mentioning...this isn't some run of the mill pediatrician appointment or I think she would have given him the boot without hesitation.
 

sureshs

Bionic Poster
Ummm... if good specialists are hard to come by then wouldn't you stick with a good one, regardless if he finds you super boring and yawns all the time around you?

This is one aspect of parenting that isn't tough.

You have not taken finances into account. Yes, it is a choice millions of parents make, going to doctors who are cheaper, because they don't have good medical insurance. It doesn't mean they don't care about their children, but what it means is that it is a shame that doctors and drug companies operate a cartel which overcharges for basic health care. They are now busy "exporting" this system to the rest of the world. Soon, yawning doctors who charge for reading your forms, then charge for the visit, and a cancelled visit and a new visit, will be found everywhere.
 

mike53

Professional
I know, there are many fibs I could tell. But if he asks who the new doc is, I wouldn't mind telling him. And if I bust out with a bunch of lies about the new guy being closer, in-network, or any of that, I will then get caught in a lie.

I see many situations in which people expect to be lied to and the polite thing to do is oblige them. In my humble opinion this is one of those situations. And if you get caught, so what?
 

Cindysphinx

G.O.A.T.
Ummm... if good specialists are hard to come by then wouldn't you stick with a good one, regardless if he finds you super boring and yawns all the time around you?

This is one aspect of parenting that isn't tough.

Good specialists are hard to come by.

Specialists who nickel and dime you or appear uninterested in the patient or are unprofessional are not "good specialists," no matter how many snazzy degrees are hanging on the wall.

You're right. This one aspect of parenting -- that is, the decision to kick the gentleman to the curb -- isn't tough. The human relations aspect is a bit tricky, but the input from some folks here has made me feel better about wading into that particular mud pit if it comes to that.
 

Steady Eddy

Legend
Good specialists are hard to come by.

Specialists who nickel and dime you or appear uninterested in the patient or are unprofessional are not "good specialists," no matter how many snazzy degrees are hanging on the wall.

You're right. This one aspect of parenting -- that is, the decision to kick the gentleman to the curb -- isn't tough. The human relations aspect is a bit tricky, but the input from some folks here has made me feel better about wading into that particular mud pit if it comes to that.
If he's yawning and probably giving other non-verbal cues that he's not checked-in, that all counts. To those who say, "Yeah, but if he's giving good medical care...", the thing is, how can one tell if it's good? Suppose he's missed something? What if later you hear, "An attentive doctor would have made a different diagnosis."? We don't know if he's attentive or just phoning it in. One goes by intuition. If that seems 'unfair' to him, T.S. In the grown-up world, it's not just what you say, but how you say it. (Try yawning during your next job interview, see if you'll be allowed to argue why it shouldn't matter.)

I think it's a mistake to add insult to injury. You switch doctors, it's his job to figure out why, (maybe billing for an appointment he shouldn't have might occur to him?). If you ever do get into a conversation with him about why you switched, (though, I wouldn't recommend it), do NOT get into an argument. You're switching. You don't have to win an argument with him in order to do so. Arguments are a waste of time. (Look what happened to the Rants and Raves section. :twisted: )
 
You have not taken finances into account. Yes, it is a choice millions of parents make, going to doctors who are cheaper, because they don't have good medical insurance. It doesn't mean they don't care about their children, but what it means is that it is a shame that doctors and drug companies operate a cartel which overcharges for basic health care. They are now busy "exporting" this system to the rest of the world. Soon, yawning doctors who charge for reading your forms, then charge for the visit, and a cancelled visit and a new visit, will be found everywhere.

You are so wrong about doctors overcharging. In pediatrics, the most common insurance is Medicaid which pays around 20 cents per dollar charged. The people making the money in healthcare are hospitals and medical supply companies. Even with private insurance(let's say an appendectomy), the doctor's charge for the operation is only around 5% of the total bill.
 

LuckyR

Legend
One of my kids has a doctor, and I am likely to dismiss him and start taking the child to someone else.

When I call this current doctor and cancel the appointment and request a records transfer, I predict he will ask me why. I am wondering what I should say and how much detail I should provide.

Part of the problem is lack of rapport with the child, which probably isn't entirely the doctor's fault. The rapport issue alone would not cause me to switch, although I think we could find someone better.

Another part of the problem is that the doctor yawns a lot when my child is talking to him during visits. Not little, stifled yawns. Big ones, as though this doctor has not slept in weeks. These yawns are so huge that my child will stop talking and say, "Bless you." I would hope my child's difficulties are not that boring.

The third part of the problem is I feel like this guy always has one hand in my wallet. His fees are high and he is out of network, which I knew from the outset, of course. But he has asked me to fill out questionnaires and forms, and then billed me $$$ for reading what I wrote.

One billing episode in particular rubbed me the wrong way. The doctor requires 24 hours for a cancellation, which is not unusual, and the full fee is owed for a no-show or late cancellation, etc. Well, we had a morning appointment scheduled and my child had an episode of the type for which the child needed treatment. Without getting into details, let's say the child had an adverse reaction to a medication the doc had prescribed. I realized that we would never make the morning appointment because I had to get the child stabilized. I called, and the doc gave me an afternoon appointment and some advice on stabilizing the child, which took a few hours.

When we showed up for the afternoon appointment, the doc said we would owe the full fee for the afternoon appointment, the cost of the telephone call, and the missed appointment fee (although he reduced that $222 fee by half). I had to cut a check for $422 that day, much of it not eligible for insurance reimbursement. This seemed extreme to me, and I felt like he should have just charged for the afternoon appointment because of the circumstances.

So. Should I give a reason why we are leaving the practice, and if so, how detailed should I be? Or should I just leave and say nothing?


A couple of ideas:

1) I would bet you would not be speaking to him directly just to transfer records, you'll be speaking to his staff.

2) I would be shocked if his staff asked why you need the records transfered.

3) I would also be suprised if he asked, partially because he is unlikely to care and partially because folks change insurance or have it changed for them by their employer all of the time.

4) However if asked I would not lie. Noone is going to make me into a liar. There is a slim chance that if you are truthful he may add some unknown piece of information that might change your mind. I doubt it, but it is possible.

5) I completely support you in changing but I wouldn't label the guy as a poor doc, merely as one whose style didn't match up with yours, an extremely common occurance.
 
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